Question:
Bc Bs Point Of Service. My exclusions in my policy states the following that:

Any service or supply to lose, gain, or maintain WEIGHT, including without limitation: any weight control/loss program; appetite suppressants; food supplements; exercise programs, equipment or memberships; or surgical procedures are excluded. Even though my primary care doctors says I need this surgery is there any hope in pursuing this issue, or am I basically without any hope at this time?    — Ann H. (posted on August 3, 2000)

August 3, 2000
My insurance has a definate WLS exclusion too. I submitted an appeal letter to my employer two weeks ago; asking them to remove the exclusion. They agreed to consider it and called the insurance company to find out how much more it would cost. The insurance company has yet to call them back. Maybe I'll hear something next week. Anyway, good luck. You're certainly not alone in this battle.
   — Lee B.

August 3, 2000
Ann, Blue Cross Blue Shield, in some states do approve depending on your Employers plan. Your exclusion seems to cover any type of weight anything and seems to be air tight. You may try researching the Obesity Lawyer for comment, but dont hold your breath. Can you choose another plan ? Just a question, that is what I have had to do because BC/BS bought my HMO.
   — Tamaria W.

August 3, 2000
I was told by a RUDE customer service rep that my policy did not cover anything for obesity, or morbid obesity. I then asked to speak to a supervisor, because someone else had already told me that this was a covered benefit for me. He backed up with the RUDE customer service rep had told me, but then added "If surgery is done to correct another problem, or for anything other than weightloss, THAT may be a different story." I believe that some insurances do not want to cover this, and try to throw you off thinking you will not push the issue. Try asking if the particular WLS (call it by name---leave out "WLS") you are asking for would be covered if it was done to correct diabetes, or some other co-morbidity you may have....and NOT for weightloss purposes. (The weightloss would just be a GREAT benefit! :) Good Luck!
   — Shelly T.

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